Surgical operating device



July 2, 1946. J. A. REYNIERS SURGICAL OPERATING DEVICE Filed NOV. 3, 1941 3 Sheets-Sheet} J ,4 2 INVENIOR.

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July 2, 1940. I J, A, R'EYME S 2,403,400

SURGICAL OPERATING DEVICE Filed Nov. 5,1941 5 Sheets-Sheet z Patented July 2, 1946 UNITED STATES PATENT OFFICE James A. Reyniers, Niles, Mich. Application November 3, 1941, Serial No. 417,657

the incision. Thus, means such as rubber gloves,

masks, and the like are now commonly used in the performance of surgical operations. Nevertheless, despite the exercise of the greatest care, infections at incisions are not infrequent, evidencing failure to completely control all vectors of infection in present methods of asepsis.

It is the primary object. of my invention to provide a device by means of which more perfect asepsis may be achieved during the conduct or performance of a surgical operation.

A further object is to provide a device of this character wherein vectors of airborne infection, in addition to vectors of infection by cont-act, may be substantially controlled.

A further object is to provide a device of this character comprising a substantially sealed housing separated into two isolated chambers, by par,- tition means including a portion of severable character and substantially impervious to the passage of air therethrough, one of said chambers constituting a patient receiving chamber and the other of said chambers constituting a working chamber, in which all vectors of infection are positively controlled. v

A further object is to provide a device of this character including a housing in which the body portion of a patient is adapted to be placed in juxtaposition to a normally air-impervious severable partition element and which is provided with an opening through which the head-of a patient may project to facilitate the administration of an anesthetic to the patient.

A further object is to provide a device of this character including. a patient receiving chamber defined in part by a severable lap cloth, with patient-supporting means within the chamber, and means for adjusting the position of said supporting means as selected with relation to the lap cloth.

A further object is to provide a device of this character comprising a housing divided into two compartments by a partition having asegerable portion impenetrable by air, said housing having an opening at one end in communication with a patient receiving compartment through which the head of a patient may project, and having a plurality of openings in communication with the other or operating compartment which are closed respectively by a transparent closure member and by rubber gloves whose free ends are secured in sealed relation at the margins of the openings.

A further object is to provide a sealed operating chamber accessible by means of gloves seal- -ing openings thereof and; having a sealed sight opening, with a large opening sealed by a loosely mounted transparent flexible air-impervious lap cloth adapted to be pressed against and to adhere to the skin of a patient.

Other objects will be apparent from the description, drawings, and appended claims.

In the drawings: Fig. 1 is a side view of the device with part broken away.

Fig. 2 is an end view of the device. Fig. 3 is a longitudinal vertical sectional view of the device taken on line 3-3 of Fig. 2.

Fi 4 is a vertical transverse sectional view of a the device taken on line 4-4 of Fig. 3.

Fig. 5 is a longitudinal horizontal sectional view of the device taken on line 55 of Fig. 1.

Fig. 6 is an end view of a modified embodiment of the-invention, with parts broken away,

, Referring to the drawings, which illustrate the preferred embodiment of the invention, numeral l0 designates a housing preferably cylindrical in shape and formed from sheet metal. Housing I0 is supported upon legs I I. I cylindrical housing I0 is provided a flange member best illustrated in Figs. 3 and 5. This flange member comprises aflatannular portion i2 having an outer diameter substantially greater than the diameter -of housing l0, andan inner diameter slightly less than the inner diameter of housing i 0. A pair of concentric flanges I3 and I4 project from one face of flange H, The spacing between flanges l3 and I4 is preferablysubstantially equal to the thickness of the material of which housing Ii) is formed, so that the ends of said housing may be received within the annular cavity definedby said flanges l3 and I4. The large diameter flange I4 is preferably/wider than the small diameter flange i3 and rivets or other suitable securing means [5 may be driven through the outer flange i l and the wall of housing Hi. If desired, a sealing gasket of any suitable form and character (not shown) may be employed to seal the joint between the housing In and the flange unit. One end of the housing 10 is closed by an end plate I8 which is of a diameter substantially equal to the outer diameter of flange l2 and which may be secured to the flange I 2 by securing means l1, such as bolts and nuts. An' annular gasket (not shown) may be interposed between the margin of plate It and the flange I2 in a position At each end of the .at'and above the center thereof.

'tion l8 secured to housing In by means of a which the interior of the housing In may be fully viewed and inspected. A plurality of apertures 24 are formed in the housing Ill, said apertures preferably being four in number arranged in pairs at opposite sides of the housing and preferably Each pair. of apertures 24 is arranged and'spaced in the housing to permit convenient insertion of the arms of a surgeon therethrough while the surgeon views the interior of the housing through the transparent closure 2!. Cylindrical members 25 whose inner edges are curved to conform to the contour of the housing 10, and from which project flanges 26, are secured to the housing In register with each of the openings 24. The outer edge of cylinder lies in a plane and outwardly projecting flange 2! lies in said plane. If so desired, an annular closure member 28 may extend between the flanges 26 and 21 in spaced relation to annularly at 33 to provide a water jacket therearound. An arm 34 projects from the chamber 3| and has pivoted at 35 to its outer end in inwardly spaced relation to the end of glove clave 3!, a link 36 positioned to extend radially relative to the glove clave. A closure 31 for the inner end of the clave 38 is mounted upon a shaft 38 and carried by the free end or link as. A cross piece 39 is free to slide upon the shaft 38 with its ends bearing against abutments it projecting into the clave at the inner end thereof. A hand grip member 4| is threaded upon the end of shaft 33 and is adapted to bear upon the cross bar 39 for the purpose of drawing inwardly upon the shaft 38 and the closure member 37 to eifect a sealed engagement between the margin of the closure 3'! and a suitable gasket mounted upon the inner end of the clave.

An arm 32 is mounted rigidly upon the outer end of the clave 3i, and projects longitudinally outwardly thereof. A cross bar 43 is pivoted to the outer end of the arm 42 at 44 and is adapted to extend diametrically of the end of the clave 3i. An arm 43 projects outwardly from the clave 33 in diametrically opposed relation to arm 42 and pivotally mounts a latch member 48 having a portion adapted to seat against a hooked end portion 4! of cross bar 43. A shaft 48 is threaded centrally through cross bar 53 and mountsa hand piece 49 at its outer end. A closure plate 50 is rotatably mounted on the inner end of shaft 43 and adapted to be pressed marginally against a reduced thickness neck portion 5! at the outer end ofglove clave 3| to seal the outer end of said glove clave. It will be underglove clave and each of the closures 31 and 53 thereof to effect a seal.

The outer end 'of the wall of glove clave 3| is preferably of stepped formation adapted to receive an annular retainer 52 which may be secured thereto in any suitable manner and which provides means for clamping the margin of the free end of an elongated rubber glove 53 at the outer end of the glove clave. The walls of the clave may be provided with passages 54 adapted for connection with a steam line or the like whereby steam may be supplied to the interior of the housing I!) and to the inner surfaces of glove 53 for the purpose of sterilizing the interior of the device including the interior surfaces of the gloves 53 and of all parts of the device.

It will be observed from the above that access to the interior of the device may be had through the gloves 53 without danger of contact of the operator or surgeon with any item or thing within the device; Thus, assuming that the device has been sterilized by steam" introduced through the openings 54 after the gloves 53 have been clamped in sealed relationto the device and the entire device is sterile, access to the device may be had by releasing the closure by manipulation of hand piece 49 and shaft 68 whereupon the operator may insert his hands and arms into the gloves in the event the inner closure 31 is open. If the inner closure 31 is closed, the operator may manipulate the hand piece M through the gloves 53 to release the same and permit it to be opened. It will be understood that suitable means (not shown) may be provided to hold the inner closure 3'! open in a manner not to interfere with the manipulation of the arms within the gloves 53 and also in a position which does not obstruct the vision of the operator through the sight opening i82i. Should it become necessary to replace one or more of the gloves due to breakage thereof, this can be accomplished without substantially destroying the sealed and infection-free condition of the device by withdrawing the gloves into the clave and sealing the inner closure 3?, thence removing the gloves 53 and replacing the same with gloves which have been sterilized through the medium of a liquid or other sterilizing medium. Thereupon, use of the device may be continued by again opening the closure 3'17. The water jacket 33 of the clave and that defined by the cylinder flanges 26 and 2?, and cylinder 2%, serve as means to cool the glove clave after the introduction of steam and their provision and use is purely optional.

At a level below the lowermost portions of the openings 2&1 in the sides of the housing Iii is mounted a, partition member 33. The longitudinal side walls of the housing it! may be provided with inwardly projecting flanges 35 upon which the opposite sides or" the partition 33 are supported and the end wall to may be provided with a like flange 632 to support one end of partition iii). Suitable strip gasket material 33 may be interposed between the flanges 6i and 32 and the partition 63, and bolts or other suitable securing means 36 may be utilized to facilitate s..- curing the partition member fit in place. Also, it may be desirable to provide the end of the partition Bil adjacent the end walls l 3 with a support 5t bearing upon the bottom of the housing it to facilitate insertion of the partition into the D housing and its removal therefrom in proper restood that a gasket may be interposed between the lation. Partition 6!) is provided with enlarge opening therein which is spanned by a lap cloth St. A clamping frame 51 may be applied to the margin of the lap cloth. 58 and bolts 68 may be utilized to secure the parts in, clamping therethrough. Flexibility is another important property which the lap cloth may possess. It will beobserved that Cellophane possess all of these properties and that other materials such as a thinsheet of rubber or rubberized fabric may also be used. In some instances, suitable means to reinforce the lap cloth maybe desired. Thus, it may be desirableto use in connection with either the sheet rubber or the Cellophane'a margin of fabric material or metal or the like. It is preferable that such reinforcing material be confined to the margin and that it does not extend over the main portion of the body of the lap cloth. The end of the housing I8 opposite that mounting closure I6 is preferably provided with an upper end plate 69 which spans the major upper portion of said end opening and is secured by bolts Hi to the flange l2. End plate 6'! preferably terminates slightly below the partition 60 and is provided with an inset downwardly projecting lower vertical flange II whose outer face is preferably flush with the inner face ofthe main body of the end plate 69. This off set flange H provides a shoulder in the plane of the flanges M on the housing whereby it may support the front edge of the partition 60 in sealed relation. The gasket 63 may extend between this shoulder and the front end of the plate 68. A second end closure plate 12 is adapted to close the remainder of the end of the housing I 0 below the plate 69. Plate 12 is marginally secured to the end flange 82 by bolts 13 and to the flange H of end plate 68 by bolts 14. Plate 12 preferably has a neck opening 15 formed centrally 6 may be then applied by passingthe head of the patient through the opening 11 therein. The neck sheet I8 may then be applied over the head of the patient and the clamping ring I1 may be employed to secure the neck'sheet 16 to the end plate 12. It will be assumed that the operating table 19 will be in its lowermost position when the patient is placed thereon, and thereupon the crank 81 will be actuated to elevate the operating table 19 to a position wherein the patient is placed against the lap cloth 66. Lap cloth 66 is therein and partially spanned by an apertured neck sheet 16 formed of rubber or like material, which is detachabiy clamped at its margin by a clamping ring '77 detachably held to place by a screw 18. Opening 15 is preferably of a size sufficient to be passed over the head of a patient and the neck sheet 76 has an opening therein of a size to fit snugly about the neck of a patient. It will be understood that the sheet E6 is of such resilience that it may be stretched sufiiciently to be passed over the head of a patient.

Within the chamber formed in the housing Ill below the partition 60 is positioned an operating table 19 extending substantially the full length of said chamber. A supporting plate 80 is secured in spaced relation below operating table 19 by members 8|. Supporting plate 80 rests upon a plurality of longitudinally and transversely spaced cam members 83 eccentrically mounted upon rotatable shafts 84 journaled in the device by bearing block 85 at least at one end. One end of one of the shafts 84 projects rotatably through the plate 84 and the outer end closure l8 of thedevice at 86 and terminates in a crank 81 positioned exteriorly of the device. A beveled gear 88 is mounted upon each of the shafts 84 and meshes with a bevel gear 89 mounted at each end of shaft 90 extending transversely and between the shafts 84 and supported in suitable bearings 9|.

It will be observed from the above that a papreferably loosely mounted upon the partition 6G and when formed of Cellophane or the like in the nature of synthetic plastic material may be moistened and pressed against the patient in the area in which the incision is to be made. Cellophane when moistened has the property of adhering to contoured surfaces against which it is pressed and tends to assume the contour in which it is pressed. The looseness of the lap cloth 66 should be sufiicient to permit the Cellophane to be pressed against the abdomen or other part of the patient at which the incision is to be made, to adhere thereto. The operation may then be performed, by severing the lap cloth or cutting away'a portion thereof td expose the local area only of the skin of the patient at which the incision is to be made, and the adhesion of the Celophane around that area will tend to effectively maintain an air-tight seal. The operation is performed by the surgeon who inserts his hand into the upper operating chamber through-the gloves 53 and who views the patient and the incision through the transparent closure 2!. Cellophane is particularly well adapted for this purpose because it is substantially transparent and conse quently the surgeon can see the patient therethrough and thus accurately proceed with the incision. Of course, it will be understood that after the Cellophane has been cut away at the vital area, the view of the surgeon is not impeded by the Cellophane. As best illustrated in Fig. 2, the device is preferably-provided with two I sets of glove claves so that an assistant may have full access to the operating chamber as may be ber will be provided with the equipment necessary to conductthe operation. Thus, lights (not shown) will be mounted within the operating supporting means in addition to the marginal portion of the partition 60 maybe provided to hold the necessary instruments and equipment which the surgeon will require. It will be understood that all of this equipment must be inserted in the device through the end thereof and for. this purpose the end plate 69 as well as the end plate an imperforate lap cloth has been applied, the

entire interior of the upper operating chamber and all contents thereof may be positively sterilized before an operation takes place. The sterile condition of thechamber is substantially retained throughout the operation by virtue of the adhesion of the Cellophane lap cloth 86 to the skin of'the patient in the area around the incision. In this connection it will be observed that Cellophane is a material of homogenous character which will stand steam without deterioration and which will be moistened by the condensation of the steam for the purpose of eiiecting the adhesion and the molding to effect the contour. ihe Cellophane is also impervious to the penetration of air, and consequently there is no possibility that air-bornevectors o1 infection can pass into the operating chamber once that chamber has been sterilized. During the operation, the head of the patient, being posi tionedexteriorly oi the device, is readily accessible for the administration of an anesthetic.

While the construction of the device illustrated in Figs. 1 to 5 inclusive constitutes the Preferred embodiment of the device, attention is directed to the embodiment illustrated in Fig. 6, which is somewhat modified. Note that housing I0 is provided with only one chamber, and that it is provided with a large opening 85 at its bottom spanned by the lap cloth 88'. Legs II are" so spaced and positioned that an operating table 95 may be positioned therebelow. Operating table 95 is provided with a patient supporting panel 98 thereabove which is provided with suitable means such as the cams 91 mounted upon the shafts 98 J'ournaled to the top of the operating table by means of which said patient support 96 may be raised and lowered'to bring the patient into contact with the lap cloth 66' or the operating device. In this embodiment the patient is not confined within a chamber, and the dimculty of app ying and removing the end plate 12 and the neck sheet I6 is eliminated. A firm adhesion between lap cloth 68' and the skin of the patient around the incision is essential in these cases in order to assure that the sterile condition of the operating chamber will be maintained. The same advantage of accessibility of the patient for administration of anesthetics is obviously present in this modified embodiment to the same a flexible glove marginally secured to said housing around one 01 said upper openings, a transparent closure sealing another upper opening, a horizontal, apertured partition, a severable sheet spanning said partition opening, said partition and sheet separating said housing into a lower patient-receiving compartment communicating with said end opening and an upper operating compartment, 9. horizontal patient-supporting member within said lower compartment.

2. A surgical operating device comprising a housing having a restricted opening at one end and two or more openings at its upper portion, a. flexible glove marginally secured to said housing around one of said upper openings, a transparent closure sealing another upper opening,

,a horizontal apertured partition, a severable sheet spanning said partition opening, said partition and sheet separating said housing into a lower patient-receiving compartment communicating with said end opening and an upper operating compartmer J, a horizontal patient-supportmeans for positioning said last named member at a selected elevation within said lower compartment.

3. A surgical operating device comprising a housing having a restricted opening at one end and two or more openings at its upper portion, a flexible glove marginally secured to said housing around one of said upper openings, a transparent closure sealing another upper opening, a horizontal apertured partition, severable sheet spanning said partition opening, said partition and sheet separating said housing into a lower patient-receiving compartment communicating with said end opening and an upper operating compartment, a horizontal patient-supporting member within said lower compartment, a shiftable support mounting said last'named member, and an actuator including an operating portion terminating exteriorly of said housing for adjusting the position of said support and last named member.

4. A surgical operating device comprising a housing having a restricted opening at one end and two or more openings at its upper portion, a flexible glove marginally secured to said housing around one of said upper openings, a transmember within said lower compartment, and a. closure for said end opening removably mounted a on said housing and having a neck opening.

5. A surgical operating device comprising a housing having a restricted opening at one end and two or more openings at its upper portion, a flexible glove marginally secured to said housing around one of said upper openings, a transparent closure sealing another upper opening, a horizontal apertured partition, a severable sheet spanning said partition opening, said partition and sheet separating said housing into a lower patient-receiving compartment communicating with said end opening and an upper operating compartment, a horizontal patient-supporting member within said lower compartment, a closure for said end opening removably mounted on said housing and having a neck opening, and an ap ertured. resilient sheet spanning said neck opening.

6. A surgical operating device comprising a housing having a restricted opening at one end and two or more openings at its upper portion, a flexible glove marginally secured to said housing around one of said upper openings, a transparent closure sealing another upper opening; a horizontal apertured partition, a severable sheet spanning said partition, opening, said partition and sheet separating said housing into a lower patient-receiving compartment communicating with said and opening and an upper operating compartment, a horizontal patient-supporting member within said lower compartment, and means for supplying steam to said housing to sterilize said upper compartment.

7. A surgical operating device comprising a housing having a restricted opening at one end and two or more openings at its upper portion, a flexible glove marginally secured to said housing around one of said upper openings, a transparent closure sealing another upper opening, a horizontal apertured partition, a severable. sheet spanning said partition opening, said partition and sheet separating said housing into a lower patient-receiving compartment communicating with said end opening and an upper operating compartment, a horizontal patient-sup porting member within said lower compartment, and sealing means interposed between said housing and the margin of said partition to normally isolate said compartments.

8. A surgical operating device comprising a housing having a plurality of spaced openings therein, a partition having a marginal sealed connection with said housing and dividing said housing into isolated upper and lower compartments each communicating with at least one of said openings, said partition including a longitudinal apertured portion, and a severable sheetspanning said aperture and of a material impenetrable by air. 4

9. A surgical operating device comprising a housing having a plurality of spaced openings therein, an apertured partition having a marginal sealed connection with said housing and dividing said housing into upper and lower compartments each communicating with at least one of said openings, a severable sheet of material impenetrable by air spanning said aperture, 2. patientsupporting table in said lower compartment, and means supporting said table in selected spaced relation to said sheet.

10. A surgical operating device comprising a housing, a horizontal apertured partition spanning the interior of said housing and secured thereto, means sealing the joints between said partition and housing, and a .severable sheet of a material impenetrable by air, spanning said aperture and having a marginal sealed connection with said partition, said housing having spaced openings each communicating with one only of the compartments defined by said partition.

11. A surgical operating device comprising a housing having a plurality of-openings and defling an operating chamber, a flexible glove sealing one opening, a transparent closure sealing another opening, a transparent sheet of flexible distensible severable material impenetrable by air and adapted to adhere to skin when wet, loosely spanning the lowermost opening, and means for marginally clamping said sheet in said opening, said chamber being sealed by said glove, closure,

I and sheet.

12. A surgical operating device comprising a housing having a plurality of openings and defining an operating chamber, a flexible glove sealing one opening, a transparent closure sealing another opening, a transparent sheet of flexible severabie material impenetrable by air and adapted to adhere to skin when wet, loosely spanning the lowermost opening, and means for marginally clamping said sheet in said opening, said chamber being sealed by the adhesion of said sheet with skin when an adhered portion of said sheet is centrally severed, and means for supplying steam to said chamber.

13. A surgical operating device as definedcin claim 11, wherein said housing has horizontal supporting surfaces adjacent to said lowermost o and is open at one end, and an end closure is detachably mounted on said housing in sealed relation.

14. A surgical operating device comprising a housing defining an operating compartment having a plurality of spaced openings, means including a flexible glove and a transparent closure for sealing certain of said housing openings, an apertured horizontal frame member spanning another openings including a transparent closure and a slack flexible glove, a flexible, transparent, severable, air-impervious sheet marginally secured to said housing to seal and span said open bottom, said sealing means and sheet defining a sealed operating chamber in said housing, an operating table positioned adjacent said sheet exteriorly of said chamber, and adjusting means for selectively spacing said sheet and .table for large area contoured air-sealed contact of said sheet with the body of a patient on said table.

16, A surgical operating device comprising a housing open at its bottom and having a plurality of spaced openings therein, means for sealing said openings including a transparent closure and a slack flexible glove, a flexible, transparent, severable, air-impervious sheet adherent to skin when wet marginally secured to said housing to seal said open bottom, said sealing means and sheet defining a sealed operating chamber in said housing, an operating table spaced below said sheet exteriorly of said chamber, and means for adjusting the vertical position of said table to position a patient for adherence of a large area of said sheet with his body around the portion of the sheet to be severed.

17. A surgical operating device comprising an operating table, a sealed operating chamber spaced above said table, said chamber having a sealed sight opening, an opening sealed by a flexible access member and an opening at its bottom spanned and sealed by a slack lap sheet, said lap sheet being formed of flexible, distensible, transparent air-impervious plastic material adapted when wetto be shaped in a predetermined contour and to adhere to the body of a patient on saidtable to maintain said chamber sealed when said sheet is severed centrally of the adhered portion thereof.

18. A surgical operating device comprising an operating table, a sealed operating chamber spaced above said table, said chamber having a sealed sight opening an opening sealed by a flexible access member and an opening at its bottom spanned and sealed by a slack lap sheet, means tor adjusting the position of one of said table and chamber units relative to the other, said lap sheet being formed of transparent, flexible, air-impervious, synthetic material adapted to adhere toa contoured surface of. the body of a patient on said table when pressed thereagainst when wet whereby said chamber will remain sealed when the adhered portion of said sheet is severed.

JAMES A. REYNIERS. 

